Introduction

Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are common childhood cancers, comprising 14.6% of cases in developed countries.Follow-up imaging is vital for treatment assessment. Guidelines recommend 18 F-FDG-PET/CT for response surveillance, but it exposes young patients to radiation. This multicenter prospective study aimed to evaluate the diagnostic confidence and reproducibility of a novel abbreviated 30-minute whole-body MRI (WB-MRI) for response assessment in children and adolescent patients with lymphoma.

Methods:

The study included 103 pediatric patients aged 0 to 18 years with pathologically confirmed lymphoma, who underwent both PET/CT and abbreviated WB-MRI at baseline and during follow-up. Image quality of abbreviated WB-MRI was evaluated using a 5-point Likert scale, and interobserver agreement was assessed. Sensitivity, specificity, and accuracy of abbreviated WB-MRI for detecting residual or recurrent disease were calculated, with PET/CT used as the reference standard.

Results

The image quality of abbreviated WB-MRI was rated good or excellent in 97% of cases, with high interobserver agreement. Abbreviated WB-MRI demonstrated a sensitivity of 90%, specificity of 96%, and accuracy of 94% for tumor response evaluation, with excellent agreement between abbreviated WB-MRI and PET/CT findings.

Discussion:

The outcomes of this multicenter prospective study underscore the potential of abbreviated whole-body MRI (WB-MRI) as a reliable and radiation-free alternative for monitoring treatment response in pediatric lymphoma patients. With a remarkable 97% rating of good or excellent image quality and high interobserver agreement, abbreviated WB-MRI demonstrates its feasibility and reproducibility. The diagnostic performance, with a sensitivity of 90%, specificity of 96%, and accuracy of 94%, positions it favorably against the conventional 18 F-FDG-PET/CT. The excellent agreement between abbreviated WB-MRI and PET/CT findings emphasizes its reliability. Importantly, its non-invasive nature and absence of radiation exposure make it a compelling option, particularly for the pediatric population. The study suggests that abbreviated WB-MRI could be seamlessly integrated into routine clinical practice, promising enhanced patient care and reduced long-term risks associated with radiation exposure. Future investigations may explore broader applications and long-term outcomes to further establish its role in pediatric lymphoma management.

Conclusion:

Abbreviated WB-MRI is a feasible and accurate imaging modality for follow-up of pediatric lymphoma patients undergoing various treatments, with high diagnostic performance and excellent image quality. The non-invasive nature and lack of radiation exposure make it a favorable option compared to PET/CT, especially for pediatric patients.

Acknowledgements

No acknowledgement found.

References

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